Transcript Pappas Spring Meeting

Association of Vascular
Surgery Coordinators
Dealing With
Problem Residents
Peter J. Pappas, M.D.
Professor of Surgery
Program Director: New Jersey Medical
School Vascular Surgery Residency
Qualifications
• Vascular Surgery Program Director for 10
years.
– Traditional 5 + 2 training program
• General Surgery Program Director for 4 years
– Second largest residency program in
country
– 86 categorical, non-designated and
designated preliminary residents
– One to two problem residents in each PGYyear per year.
Definition of a “Problem” Resident
• Academic Issues
– Failure to progress
• Poor knowledge
acquisition, poor
clinical judgement,
patient safety issues and
so on.
– Learning Disabilities
• AADD
• Dyslexia
– Substance Abuse
• Alcoholism
• Drug Dependence
• Non-Academic Issues
– Sexual Harassment
– Racial Discrimination
– Residency verification
for Hospital
priviledging
• What do you report if
the above occurred?
CIR
2009-2010
Contract
Grievance
And
Disciplinary
Procedures
Identification of Specific Issue
• First line of defense is the rotation evaluations
– Rotation evaluations will often be first notification
of a potential problem.
– Monthly/Bi-monthly residency review committee
is crucial
• Oral discussions reveal issues not documented in
rotation evaluations.
• Documentation of the oral discussions in the semiannual evaluation is crucial especially if items not
documented in rotation evaluations are discussed.
Residency Review Committee Meetings
• Avoid personality discussions.
• Use competencies to identify, dissect and specify
exact academic issue.
• Develop uniform set of phrases that explain the
deficiency identified.
• Use these phrases in semi-annual evaluation. They
will serve as the basis for a remediation plan if
necessary.
Competency Deficiency Phrases
• Knowledge Base
– Poor fund of textbook knowledge for
current PGY level.
– Poor textbook knowledge base foundation.
• Clinical Judgement
– Inability to translate textbook knowledge
into clinical decision making.
Competency Deficiency Phrases
• Oral presentations
– Inability to present pertinent data in a succinct
manner during walk rounds.
– Demonstrates disorganized and illogical
thought processes during formal oral and
written presentations.